Open fetal myeloschisis closure: pearls for uterine exposure and closure

Fetal closure of an open neural tube defect offers the potential to limit progressive neurological injury and improve long-term outcomes. Myeloschisis presents unique challenges due to the technical complexity of mobilizing the skin and achieving adequate soft tissue coverage, particularly in the sacral region. In this video, the authors demonstrate an open fetal myeloschisis closure in a fetus with an S1-level defect and associated grade 3 hindbrain herniation. The preoperative counseling process, surgical technique, and perioperative course are highlighted, with a focus on pearls for the exposure and closure of the uterus. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25231.